Virtual Pediatric Hospital(tm) : A digital library of pediatric information

Home | Search | About Us | FAQ | Reviews | Contact Us
Additional pediatric resources: SearchingPediatrics.com | Pediatric Commons Facebook iconTwitter iconRSS icon | PediatricEducation.org | GeneralPediatrics.com

Virtual Pediatric Hospital: Paediapaedia: Neonatal Chest with Normally Positioned Extracorporeal Membrane Oxygenation (ECMO) Catheters Paediapaedia: Neonatal Chest Diseases

Neonatal Chest with Normally Positioned Extracorporeal Membrane Oxygenation (ECMO) Catheters

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Patient in respiratory failure.

Etiology/Pathophysiology:
ECMO is a technique for pulmonary bypass, used to support patients with severe respiratory and or cardiac failure who are not responsive to conventional therapy. The idea is to allow the lungs time to heal with mechanical ventilation being reduced to minimum levels. Through large bore canulas unoxygenated blood is removed from the body, passed through the ECMO circuit which oxygenates the blood, and then reintroduced into the body through a large bore canula. The most common indications for ECMO are meconium aspiration, congenital diaphragmatic hernia and neonatal pneumonia which are severe enough to result in pulmonary hypertension and right to left shunting.

Pathology:
Not Applicable

Imaging Findings:
The Endotracheal tube (ETT), Nasogastric tube (NGT), Feeding tube (FT), Central venous line, Umbilical arterial catheter (UAC), and Umbilical venous catheter (UVC) tips should be in their normal positions. The tips of the ECMO arterial and venous catheters are often non-opaque, and their exact positions are often difficult to ascertain.

In arterial-venous (AV) ECMO the tip of the arterial catheter should be within the aortic arch and the tip of the venous catheter should be within the right atrium. icon gif

In venous-venous (V-V) ECMO the tip of the sole venous catheter should be within the right atrium pointing towards the tricuspid valve. icon gif

Body wall edema is present because the patient is paralyzed while on the ECMO circuit.

The lungs are opaque due to a combination of fluid in the alveoli, atelectasis, and effusion.

DDX:
Not applicable

References:
See References Chapter.

Section Top | Title Page


Additional pediatric resources: SearchingPediatrics.com | Pediatric Commons Facebook iconTwitter iconRSS icon | PediatricEducation.org | GeneralPediatrics.com
Home | Search | About Us | FAQ | Reviews | Contact Us

Virtual Pediatric Hospital is curated by Donna M. D'Alessandro, M.D. [Google+ Profile] and by Michael P. D'Alessandro, M.D.

Please send us comments by filling out our Comment Form.

All contents copyright 1992-2014 Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. and the authors. All rights reserved.

"Virtual Pediatric Hospital", the Virtual Pediatric Hospital logo, and "A digital library of pediatric information" are all Trademarks of Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D.

Virtual Pediatric Hospital is funded in whole by Donna M. D'Alessandro, M.D. and Michael P. D'Alessandro, M.D. Advertising is not accepted.

Your personal information remains confidential and is not sold, leased, or given to any third party be they reliable or not.

The information contained in Virtual Pediatric Hospital is not a substitute for the medical care and advice of your physician. There may be variations in treatment that your physician may recommend based on individual facts and circumstances.

URL: http://www.virtualpediatrichospital.org/

This website is certified by Health On the Net Foundation. Click to verify. This site complies with the HONcode standard for trustworthy health information:
verify here.